South Beach diet
The South Beach diet is a three-phase, carbohydrate- restrictive diet. It emphasizes foods that are low on the glycemic index (GI) and low in saturated fat, such as lean meats, vegetables, cheeses, nuts, and eggs.
Unlike other carbohydrate-restrictive diets, such as the Atkins and Zone diets, the South Beach diet promotes ‘‘good’’ carbohydrates, such as whole grains and fruit.
According to Agatston, benefits of the South Beach Diet include:
1. rapid weight loss followed by lifetime weight control
2. loss of weight from the belly region
3. fewer hunger pangs because of slower carbohydrate breakdown and frequent small meals
4. a heart-healthy approach to fats
5. decreased risk of developing cardiovascular disease.
The initial rapid and significant weight loss is reported to be 8–13 lb(4–6 kg) in the first two weeks. After the first two weeks, weight loss continues at a slower rate, averaging 1–2 lb (0.4–1 kg) weekly. In addition to weight loss, the diet can reduce cholesterol and insulin levels, thus reducing the risk of diabetes and heart disease. Some people report that the diet is easy to follow because it is designed to eliminate cravings and has more flexible food options after the first two weeks.
In his book, The South Beach Diet, Dr. Agatston states that ‘‘this diet is not low-carb. Nor is it low-fat.’’ Instead, the diet focuses on eating the ‘‘good’’ carbohydrates (fruits, vegetables, and whole grains) and ‘‘good’’ fats (olive oil and nuts) rather than eliminating them from the diet entirely.
Dr. Agatston based the core of his dietary plan around the glycemic index (GI). The glycemic index compares foods on a scale of 1–100 for how much they increase the level of glucose (sugar) in the blood.When people eat, the level of glucose in their blood increases. How much it increases depends on the foods they eat. ‘‘Good’’ foods with a low glycemic index (below 50) raise blood sugar less than ‘‘bad’’ foods with a high glycemic index (above 50 or above 65 depending on which authority is consulted). When blood glucose levels increase, cells in the pancreas release the hormone insulin. This signals cells in the body to convert some of the glucose into a compound called glycogen that is stored in the liver and muscles and to convert some into fat, stored in fat cells. When blood glucose levels go down, different cells in the pancreas release the hormone glucagon. Glucagon signals cells in the liver and muscle to release glycogen, which is converted back into glucose and is burned by the body. If glucose levels continue to be low, fat is also burned for energy.
When people eat foods that contain a lot of sugar or carbohydrates that break down rapidly in the body into glucose (the ‘‘bad’’ carbohydrates of the South Beach Diet) their insulin level spikes. When people eat carbohydrates that break down more slowly into glucose (the ‘‘good’’ carbohydrates of the South Beach Diet), their insulin level rises more slowly and does not reach as high a level. When someone eats too many sugary foods too often, they secrete a lot of insulin, and eventually cells in the body may become insulin resistant, which can lead to atherosclerosis and diabetes. According to Dr. Agaston, eating these low-GI foods reduces the risk of insulin resistance, and can even eliminate the body’s craving for high-GI foods.
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The South Beach diet consists of three phases. Phase one is the strictest part of the diet and lasts for two weeks. The purpose of Phase one is to banish the dieter’s cravings for high-GI foods such as bread, rice, potatoes, pasta, and sugar. Alcohol, fruits, cereal, and such vegetables as carrots and corn are also restricted during phase one. Instead, protein-rich foods are emphasized, such as lean meat, fish, eggs, cheese and nuts. Some types of vegetables are also encouraged. Coffee and tea are allowed during this phase of the diet. Three regular-sized meals are eaten each day, supplemented by mid-morning and mid-afternoon snacks as well as dessert. During this period, the body chemistry is believed to change dramatically until cravings for high-GI foods are eliminated and insulin resistance is improved/lowered. In addition, rapid weight loss is typically experienced. The total calorie intake during phase 1 is usually between 1,200 and 1,400 per day.
Phase two reintroduces several of the restricted foods and encourages eating from all the dietary food groups, the expected result being that the body will neither crave high-GI foods nor store food as excess fat to the same degree. Such high-fiber carbohydrates as whole-wheat pasta and bread and most fruits are now permitted.Moderation remains the key
to success for this phase and low-GI foods are strongly encouraged. Phase two continues until the dieter reaches his or her ideal weight, with weight loss ideally averaging one to two pounds per week. Phase three, the ultimate goal, focuses solely on weight maintenance. Having reached the ideal weight, the diet now becomes a lifestyle from this point forward.
Basic dietary techniques are still maintained. Only the high-GI foods and ‘‘bad’’ fats from the previous two phases continue to be restricted. Altered body chemistry will promote long-term cardiovascular health and reduce the risk of diabetes. Should weight gain occur, phase one of South Beach diet is reintroduced and the diet is begun again.
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There are no initial preparations required for the South Beach diet. However, as with all diets, dieters should consult with a physician before beginning the diet. Blood testing for insulin, glucose, and cholesterol levels is suggested. It is especially important for dieters taking medications for medical conditions such as heart disease to consult a physician before going on the South Beach diet. Similarly, diabetics on insulin or other medications are advised to have a doctor monitor their blood sugar regularly and determine if they are at risk of kidney impairment while on the diet. It is also recommended that a registered dietitian be consulted to determine the dietary needs of certain medical conditions, such as pregnancy.
The South Beach diet is not recommended for people suffering from or at risk for kidney problems. The diet’s high protein content can place increased strain on the kidneys, possibly causing long-term damage as well as kidney stones and bone loss. Additionally, the possibility of ketosis-induced dehydration during phase one can increase the risk of further kidney impairment. Dehydration occurs when the body experiences water loss with accompanying loss of important blood salts like potassium and sodium. Ketosis occurs when carbohydrates are not available and the body burns an excessive amount of fat, during which some ketones, or fat fragments, are excreted. The restrictive nature of phase one may also induce mineral and vitamin deficiencies. Remaining in phase one of the diet for longer than two weeks greatly increases the risk of losing bone and muscle mass. Dieters should remain in phase one for no longer than three or four weeks.
Some nutrition professionals express concerned that the South Beach diet menus, provided in the book, lack important nutritional information and detailed portion sizes as well as specific substitutes for foods the dieter cannot or will not eat. They suggest that these aspects, combined with the restrictive nature of the diet, can make sticking with the South Beach diet on a long-term basis difficult for some people. Additional objections include that limiting milk may lead to calcium deficiency and limiting and whole grains even in the maintenance phase may lead to deficiencies in dietary fiber and B-complex vitamins. Also, some nutrition professionals assert that the diet does not emphasize an exercise regimen and that exercise is vitally important to avoid the loss of muscle and bone mass, especially during phase one of the diet.
Despite Dr. Agatston’s claims to the contrary, the South Beach diet is both a low carbohydrate and a low fat diet. For this reason, one main concern regarding the diet is the risk of ketosis, especially during phase one. Ketosis can cause such symptoms as dehydration, dizziness, heart palpitations, fatigue, lightheadedness, and irritability. Hypoglycemia, low blood sugar, headaches, and excessive fluid loss are also commonly associated with this diet. Cramping and tired muscles can be caused by salt depletion. Kidney function can be impaired, especially by the diet’ high protein requirement, possibly leading to serious health issues. These side effects typically lessen or fade at the beginning of phase two when a more balanced diet is undertaken.